Organization
DR WISDOM TEETH
Active
Other names
Dr Wisdom Teeth
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY FENN DMD (OWNER)
(702) 325-7627
Entity
Organization
Contact information
Practice address
287 E HUNT HWY STE 101, SAN TAN VALLEY, AZ 85143-5096
(833) 394-7366
Mailing address
287 E HUNT HWY STE 101, SAN TAN VALLEY, AZ 85143-5096
(833) 394-7366
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
D009399
AZ
Other
Enumeration date
06/08/2018
Last updated
06/08/2018
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